Individual
JASON MAYBERRY
Active
Individual
JASON MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA19289
CA
363AS0400X
Surgical Physician Assistant
Primary
PA60698165
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PA192890
MEDICARE INDIVIDUAL PTAN
—
01
—
PA19289
LICENSE
CA
Enumeration date
11/15/2006
Last updated
06/17/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up